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Patient Zai, female, 27 years old. High fever without aversion to cold, body pain and stiff neck, extreme thirst and excessive drinking, persisting for more than 10 days. Pulse is full and large, tongue texture is red with thick and greasy coating. Previous treatment with Minor Bupleurum Decoction did not resolve the condition. The syndrome is attributed to dampness-heat lingering in the Taiyang and Yangming meridians. The treatment should aim to open the yang qi mechanism and clear-heat purge the Yangming to expel the pathogen externally. The prescription combines Cinnamon Twig Decoction and White Tiger Decoction from the "Treatise on Cold Damage Diseases" with modifications. Prescription:
Cinnamon Twig 9g, Pueraria Root 2g, raw Gypsum 15g, stir-fried Anemarrhena 6g, rice 9g, Liquorice Root 6g, stir-fried Fresh Ginger Rhizome 3 slices, Chinese Date 3 pieces
. After one dose, the fever slightly subsided, but other symptoms remained unchanged, with additional chest tightness, retching, bitter taste in the mouth, spontaneous sweating, and constipation. This indicates yang pathogen sinking inward, requiring therapy to release both internal and external pathogens. The treatment was switched to Major Bupleurum Decoction from the "Treatise on Cold Damage Diseases". Prescription:
Stir-fried Bupleurum 9g, Pro Formula Pinellia 9g, stir-fried to yellow Scutellaria 6g, stir-fried Immature Orange Fruit 6g, stir-fried Hangshao 6g, Rhubarb Rhizoma 6g, baked Fresh Ginger Rhizome 3 slices, Chinese Date 3 pieces
. After one dose, bowel movements normalized, irritability settled, chest tightness and bitter taste in the mouth resolved, but fever did not completely subside, and joint pain persisted with a thick tongue coating. This suggests excessive dampness obstructing the Taiyang meridians and collaterals. The treatment should focus on removing dampness and unblocking collaterals. The prescription combines Ephedra plus Atractylodes Decoction from "Jingui Yaolue" with Ma Xing Yi Gan Decoction. Prescription:

Ephedra 6g, Bitter Apricot Seed 9g, Cinnamon Twig 9g, White Atractylodes Rhizome 15g, Coix Seed 15g, Liquorice Root 6g
. After one dose, body pain completely disappeared, fever subsided, and the body cooled. Follow-up treatment with Sweet Dew Decoction (Unprocessed Rehmannia Root, Prepared Rehmannia Root, Asparagus Root, Ophiopogon Tuber, Virgate Wormwood, Skullcap Root), Loquat Leaf, and Liquorice Root led to full recovery.